Provider Demographics
NPI:1730174046
Name:ARAYAN, RIZWAN A (MD)
Entity type:Individual
Prefix:DR
First Name:RIZWAN
Middle Name:A
Last Name:ARAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8043
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-8022
Mailing Address - Country:US
Mailing Address - Phone:773-220-8835
Mailing Address - Fax:
Practice Address - Street 1:820 W JACKSON BLVD STE 310
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3062
Practice Address - Country:US
Practice Address - Phone:312-757-4647
Practice Address - Fax:312-724-7647
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-112395208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-112395-1Medicaid
IL036-112395-1Medicaid
ILK20026/209384Medicare ID - Type Unspecified